Chairs

Last Friday a reclining electrically adjustable chair arrived for Rosemarie. It is on loan from the local authority OT Dept for a few weeks while we evaluate it and convince the Care Home to buy one for her. 

The OT who arranged it turned up to supervise the installation and to gauge Rosemarie's reactions (she said she could tell in the first few minutes if the chair was suitable). This is another professional I clicked with immediately: knowledgeable, clear and confident. She explained the features and operation of the chair to Good Nurse, two carers and me, and then Rosemarie was hoisted into it. Apart from the trips to hospital on a stretcher, and the aborted experiment on Christmas Day, I think this is the first time she has been out of bed in nearly three months.

Within seconds of being lowered into the chair and having the hoist straps removed she was smiling. I think I could see why. Her neck was supported, there was lumbar support and the whole thing was soft and comfortable. It was like a moulded sports car seat. I was trying to film it but there were too many bobbing heads.

We wheeled her around the corridors for a while to show her the lounges and some of the people she hasn't seen for so long. I don't think she recognised many (if any) but the change in scenery had a dramatic effect: she seemed much more engaged and alert. She began verbalising with clear intonation and started to move her arm in a much more purposeful way. 

Saturday was even better. Our friend Celia was down from Derbyshire to visit her and when we arrived we met Rosemarie sweeping round the corridor corner in her chair, smiling and chuckling, on her way to her room for a rest. (The OT had stated that Rosemarie should not be in the chair for more than about 3 hours and should be put back to bed for a rest if she showed signs of tiredness or discomfort). It was near supper time and Rosemarie seemed in good spirits so we went for a quick tour of the Home again. 

We fed her in the chair in her room at supper time and, as the OT predicted, it was a lot easier and quite a bit quicker. There was a regular 'chatter' from her which, although unintelligible, communicated good humour. 

Things began to unravel after supper.

Her room is quite small and the chair is unquestionably quite large. Getting the chair and the hoist in the room in the right relative positions requires well developed spatial skills. When the carers came to put her to bed they were confronted by Change and Change Is Not Good. There was much muttering about how the chair was too big for the room, how everything would have to be changed round, how the chair was all wrong, and how nothing would work. 

Good Nurse was supposed to do a new Care Plan to cover the new situation, and communicate this to other duty nurses and staff. I have never been happy with the way information is distributed at the Home - it is very hit and miss.

Sure enough Sunday saw staff come on duty who had never seen the chair before and had only a garbled message from Good Nurse about not getting Rosemarie up until I arrived (not accurate at all). None of the staff who had been trained by the OT were on duty, nor was anyone who had been around Saturday.

So, in the absence of any information they started making it up.

They got Rosemarie up just after breakfast and moved her into the lounge. They played around with the settings of the chair so it tilted back too far ("She might fall out") and lifted her knees far too high ("That's the best way to do it. I know about these things"). Celia arrived about 2.30 (I was off buying new nighties for Rosemarie) and discovered that Rosemarie had been in the chair for at least 5 hours. She was clearly uncomfortable and tired. Celia asked for Rosemarie to be put to bed and was told shortly that she had to stay up because the staff were too busy to keep getting Rosemarie in and out of bed. She would stay out until it was time to put her to bed for the night.

I am always acutely conscious in these situations that I am not there most of the time and it is unwise to piss the staff off too much (for Rosemarie's sake). I generally have a good relationship with the staff but this day everyone seemed stressed and grumpy and nobody seemed to be able to find any instructions that supported my case. The nurse on duty was unfamiliar with the floor and was clearly uncomfortable. I made enough fuss to be noticed and Celia and I concentrated on trying to make Rosemarie as comfortable as possible in the chair until she was put to bed.

It seems to have been the right amount of fuss because the following morning the Care Home Manager and Care Manager had a meeting with Good Nurse to discuss how Rosemarie was going to be managed. I wasn't invited to this meeting of course, but they pretty much accepted the plan suggested by the OT, and everybody seemed to fall over themselves to be nice to me when I arrived.

And then in the afternoon a technician from the Wheelchair Service arrived. In the dim distant past he had visited to reassess Rosemarie when she began seriously leaning. He said at the time there was nothing that could be fitted to her wheelchair to provide sideways support, but various things like padded arms, back extension, and footbox could help with other issues. He said he would arrange it.

Weeks turned into months and nothing arrived. Phone calls elicited the repeated statement that parts were on order. Rosemarie's deteriorating condition rendered the solution irrelevant. I did not think any more about it. 

But the OT who organised the loan of the new chair had gingered them up and I received a call out of the blue from the technician who had been asked by the OT to reassess Rosemarie.

He arrived with all the bits, but after one look at Rosemarie he agreed that her existing wheelchair could not be modified.

But it turns out there is another wheelchair they could supply from their stock. It is not as comfortable as the one we want but it is more suitable for trips outside and would be supplied free.  So we are getting one on approval in a few weeks when delivery can be arranged. Rosemarie can try it out and I am going to ask the OT if she can come and assess it. It would have to be phenomenal to oust the Hydro chair, but it could supplement it. One chair for indoors (longer term use) and a more lightweight but still supportive one for short duration trips out to the garden. So maybe if I can swing it she will go from having no suitable chairs to having two.

I think she is worth it.